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Proteus

LAB WORK
  • ​G(-) rod; species encountered in clinical practice include P. mirabilis, P. vulgaris, P. penneri

TREATMENT OPTIONS
  • Typically come up as susceptible to nearly all antibiotics EXCEPT tetracycline and nitrofurantoin (fluoroquinolone and Bactrim resistance is also on the rise), BUT a portion of strains produce AmpC, a beta-lactamase which the organism can increase production of during therapy when exposed to certain beta lactams. These organisms may show resistance to ampicillin and 1st generation cephalosporins.
  • Use cefepime, a carbapenem, or a non beta-lactam even if cultures show sensitivity to other beta-lactams (and especially if patient has received doses of other beta lactams during their stay), otherwise may lead to resistance development during therapy and treatment failure.
    • Once sensitivities are available, de-escalation to a non-beta-lactam is possible if sensitive

CLINICAL NOTES​
  • Common GI colonizer as part of normal flora
  • P. vulgaris and P. penneri (generally more resistant) more commonly associated with healthcare setting
  • Not a common cause of pneumonia or bacteremia, more likely to be involved in UTI
  • COVID
    • INPATIENT >
      • CONSIDERATIONS & LABS
      • REMDESIVIR
      • OLUMIANT
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